A Personal Journey Through the Past and Future of Mental Illness and Addiction

“‘I have never seen a case worse than you, Patrick. You’ve been at this for so long, and the fact that you’ve survived and you’re still doing it almost makes you more dangerous. You’re able to manage it, just like your father managed it….’

He [Chris Lawford, Patrick Kennedy’s cousin] said he knew that at any given moment, I could say I wanted to go off to Australia with all my money and drink and drug myself to death. What he didn’t know, and neither did Amy, was that I had considered such a plan.”Patrick J. Kennedy,A Common Struggle

I never thought I’d read a Kennedy memoir, we’ve been so saturated through the years with media coverage about the Kennedy family. Usually, I read literary memoirs, and this one isn’t. But I knew I had to read A Common Struggle, given my interest in mental health issues and wanting to see things change for the better, for once, rather than for the worse.

Patrick Kennedy has bipolar disorder, severe anxiety disorder, and has struggled with addiction to alcohol and prescription medication most of his life. His memoir, A Common Struggle,co-written with Stephen Fried, describes in excruciating detail how Ted Kennedy’s son managed somehow to keep this a secret (more or less) even as he served as Congressman from Rhode Island for many years.

In fact, Patrick’s entire nuclear family struggled with addiction, and all of them went through rehab at least once, if not multiple times – all except for Ted Kennedy. Not that he didn’t need it – Ted Kennedy’s family staged an intervention once, but Kennedy refused to acknowledge or accept that he had an addiction to alcohol.

This is a fascinating read. The Kennedys have a remarkable record of public service and, despite his debilitating mental health and addiction issues, Patrick Kennedy led the fight for successful passage of the Mental Health Parity and Addiction Equity Act. Given our complex and often dysfunctional political system, this is truly an achievement, even though the act, which requires insurance coverage of mental illness and addiction equal to coverage of physical illnesses, hasn’t yet been fully implemented.

Patrick Kennedy and others had to fight hard to make sure that addiction was included along with mental health. This was an enlightened step. It’s about time, since there is an epidemic of opioid and heroin addiction and overdose in the US. Only now are attitudes beginning to change so that addiction is increasingly viewed as a health problem, not a crime or a personal weakness.

Patrick ultimately decided that he couldn’t sustain his lifestyle as a Congressman and handle his addiction and mental health issues, so he eventually left Congress. He is currently the leading advocate in the US for mental health and substance abuse care, research and policy.

I’ve sometimes been dismissive of the Kennedys and their privilege, but Patrick’s memoir made me realize how devoted the extended family is to public service and what a difference they’ve made on many fronts. If you are interested in mental health and substance abuse issues, and/or if you want to become an advocate for better mental health care and research, I think you’ll get a lot out of Kennedy’s memoir. He weaves into his personal story a detailed history of mental health legislation in this country – legislation that is woefully lacking.

There are fantastic appendices, too, that summarize the many issues we need to advocate for and change, and that list the most prominent mental health and substance abuse support groups and organizations in the US.

I get discouraged about the lack of funding and services for people who suffer from mental illness and addiction and the long road it has been over the years to see improvement. Seems like common sense that we’d want to make changes for the better, but sadly our priorities are elsewhere. This is a shame, because these issues affect one out of five families – so is there anyone among us who hasn’t been touched in some way by mental illness or addiction?

I’m also proud to report that NAMI Rochester has such an extensive and devoted cadre of family members and volunteers working on behalf of mental health education and advocacy, they have been named the TOP NAMI affiliate in the country for 2016. They will be honored at the NAMI National Convention in July.

NAMI Rochester Streakers take the lead for NAMI Walks.

NAMI Walks leaving the Village Gate in Rochester’s Neighborhood of the Arts.

“…so we just took her home to wait for a bed in the good hospital, which was going to take a few days, according to him [the psychiatrist]. He said to keep a watch on her, remove all the knives, put sheets over the mirrors so she can’t see herself, because that would set her off. And of course, make sure she doesn’t kill herself, or anybody else.” June, from Daughters of Madness, when she and her sister (ages 13 and 15) sought treatment for their mother in the 1980s.

I’ve been reading Growing Up With a Schizophrenic Mother by Margaret J. Brown and Doris Parker Roberts, and Daughters of Madness by Susan Nathiel. After my last post, Children of Mental Illness, I was thrilled to hear from author Susan Nathiel. Susan tells me she will publish Sons of Madness this August. There are fewer interviews in her forthcoming book than in Daughters of Madnessbecause male volunteers were harder to find. Susan says, however, that the interviews included in her new book are excellent. I’m glad to hear about this new publication, because there still isn’t a lot written about the experience of growing up with a seriously mentally ill parent.

When I was coming of age in the 1960s and 1970s, I thought I was the only daughter in the world who had a mother with schizophrenia. Many of the individuals interviewed in these books are baby boomers like me. Some of us had encounters with mental health professionals who were compassionate and helpful, but more often they were uninterested in helping children and teens with a mentally ill parent, unaware of their needs, or not permitted to help by the mentally ill parent or another adult family member.

Back then, there was no NAMI (National Alliance on Mental Illness). There were no support groups for families of the mentally ill, little in the way of books or educational materials about mental illness, and no Internet where you could plug in a keyword such as “schizophrenia” and retrieve information. Sometimes, I think that dearth of information and the fact that mental illness was kept secret by all concerned were the reasons I went into communications and later medical librarianship. I wanted a voice that could be heard, and I wanted to give people the vital health information they needed and deserved.

Thankfully, things have changed, though I don’t think they’ve changed enough. There are excellent mental health family services at the medical center where I work, and we librarians at the medical library often give information and educational materials to patients. One of our librarians specializes in providing mental health information to patients and families. But mental health care in our country still needs fixing; unfortunately, too many patients and families don’t get the services they need.

When I was a teenager, it didn’t occur to my mother’s mental health care providers that I might need to know her diagnosis. Now, when I give a patient or a family member health information, I feel I’m doing a little bit to validate their experiences and make their lives better. But I’m also making up for what I never got until quite late in the game. I’m saying to patients and their families: You matter. You need to know. You deserve the best information we can give you.

Book Giveaway

In celebration of my first anniversary as a blogger, I’m giving away a book to one lucky person who leaves a comment on any of my posts here at Books Can Save a Life in February. There are still a few days left to join the conversation and add your name to the drawing, so please do!

….what a courageous little girl she was…she kept me alive. I feel such pride in her…

These are the words of the daughter of a mother with serious mental illness looking back on her childhood in Growing Up With a SchizophrenicMother,by Margaret J. Brown and Doris Parker Roberts.

I never thought about it quite this way before, but I’m a member of a select group: adult children of a mother with schizophrenia.

There are more people who have a mother with schizophrenia than you might think – millions, in fact – because often schizophrenia doesn’t manifest until after a woman has children.

But most of us believe we’re the only ones. No one else could possibly have had the bizarre, surreal childhoods we had. We believe this because we grew up in layers of isolation, self-imposed by ourselves and our families due to embarrassment, shame, and the illness itself, and imposed from the outside by others: extended family, our communities, and society.

We were rarely asked about what was going on with us and our families, though in most cases it was obvious there was something wrong. People didn’t want to hear about mental illness because it scared them and made them uncomfortable. If we did try to confide in someone, which was rare, we were explicitly told not to talk about it or made to feel the topic was inappropriate. Often, the mentally ill parent wanted nothing to do with others and drove everyone away.

I grew up in the 1950s, 60s, and 70s, when the stigma and silence surrounding mental illness were even more profound than it is today. Many of the adult children in the two books I’ve been reading are of my generation.

Growing Up With a Schizophrenic Mother, by Margaret J. Brown and Doris Parker Roberts (2000), and Daughters of Madness: Growing Up and Older with a Mentally Ill Mother by Susan Nathiel (2007), contain excerpts from in-depth interviews with women and men who grew up with a seriously mentally ill mother. At the time they were researching their book, authors Brown and Roberts found little about the effects of mentally ill parents on children in the psychiatric literature, though that is changing. Margaret Brown and Susan Nathiel grew up with mothers who suffered from schizophrenia and, like many with similar backgrounds, both became therapists. Nathiel and her father weathered decades of her mother’s schizophrenia but never once spoke about it with each other until Nathiel was in her fifties.

The authors concede these books may be skewed because they are the stories of high-functioning survivors, many who now have loving, stable families and successful careers as accountants, therapists, lawyers, and sales people. Those not so resilient are less likely to volunteer to speak about their pasts. Yet despite the measure of success achieved by the adult children in these books, in many cases the stories they tell can only be described as horror stories. The adult children themselves have an unshakeable, lifelong sense of loss and loneliness, and some do not even have a solid sense of their own selves.

One little girl, Naomi, learned to follow other children to school when she and her mother moved to a new neighborhood, as they often did, and enroll herself because there was no one else to do it. Other children learned how to cash welfare checks, go to the grocery store for food, and negotiate with landlords.

In the very worst of these stories, seriously mentally ill mothers tried to kill their children (by poisoning, turning on gas stove burners, parking on railroad tracks). Yet, in all of these instances, the children remained in the care of their mothers.

These extreme cases are rare, and it’s important to remember this was the mental illness speaking and not the true volition of the mentally ill mothers themselves.

Often, the parents divorced and the children lived alone with their ill mothers. In some cases, fathers tried to gain custody, but in decades past it was customary for mothers to have custody. In other cases, the fathers had serious psychological issues of their own or they chose to have little or no contact with the family.

I was fortunate for a number of reasons: my parents stayed together, we were stable financially, and my mother was relatively high-functioning. Though she could be hostile, frightening, and unpredictable (my siblings and I were routinely left alone with her), she was never violent in the way some of the mentally ill mothers described here were, and there was no physical abuse.

It was clear to extended family, friends, and neighbors that something was wrong with my mother, and if you were on the outside looking in I don’t see how you could be certain she wasn’t dangerous. (I found out years later my father discussed with his parents the possibility of us living with them.) Our family doctor, our minister, my aunts and uncles knew, but no one said anything to me about it. As an older teenager, I turned to my aunt for some help, but throughout my childhood and adolescence I remember only two adults who initiated conversations about my mother: my piano teacher and my grandmother.

When I was ten or eleven, my teacher asked me if everything was alright at home. I was too embarrassed and too fearful of the consequences to confide in her, so I said everything was fine, though I know she didn’t believe me.

I had always considered my maternal grandmother to be my best friend. We were very close, and sometimes she’d spend the night, which I loved. But one night when she was visiting, my mother had a severe psychotic episode. My grandmother was so frightened and upset she called a friend to come and get her. “I’m not staying another minute in this house,” she said. My father wasn’t home. It was past midnight when I stood at the living room window and watched my grandmother drive away.

When I next saw my grandmother, she said, “I spoke with my doctor, and he said your mother could do harm to you kids.”

I didn’t know what I was supposed to do with that information; I was twelve.

When I was 19, I began to try and find help for my mother. (She had never seen a psychiatrist. There was nothing wrong with her, it was the world that was crazy.) I made an appointment with a social worker at the hospital nearby, which had a new psychiatric wing. It was my first encounter with the mental health system and, for the life of me, I can’t fathom why the social worker seemed irritated I had even made the appointment in the first place. She asked me several times if my mother was going through menopause. I didn’t know much about menopause, but I thought my mother’s behavior was awfully extreme for menopause. Finally, based on the cursory information I told her, the social worker told me not to do anything, because nothing could help my mother.

Ultimately, my mother was hospitalized for a time (that is another story), but no one else in our family was assessed or given counseling. In fact, I wasn’t told my mother’s diagnosis, and I felt I didn’t have the right to ask. I believe the mental health community was of little help to our family, and it failed my mother, too, in crucial ways.

A couple of years later when I was living in New York, I saw a therapist who urged me to talk with my mother’s psychiatrist about her diagnosis. After some badgering, the very reluctant Dr. M – who said my mother had a right to privacy and confidentiality – finally granted me an appointment. I’m not exaggerating when I say he looked like Freud himself. Dr. M was intimidating and formal, without an ounce of warmth or ease. He finally begrudged me my mother’s diagnosis. As far as he could tell, he said, she had paranoid schizophrenia.

This was in 1975. Today there are many compassionate and devoted mental health professionals, and there isn’t as much silence about mental illness as there used to be, but we have a long way to go. The mental health system is far from what it should be, and public stigma and denial are still pervasive. I’m sure there are children with seriously mentally ill parents living in situations similar to those I’ve described.

The problem of mental illness can’t be borne and solved by the families alone. They need our help.

Let’s Connect

If stories come to you, care for them. And learn to give them away where they are needed. Sometimes a person needs a story more than food to stay alive. That is why we put these stories in each other's memory. This is how people care for themselves.